ZipRecruiter

Log In

1

Insurance Utilization Review Jobs in Rochester, NY

DePaul

Residential Supervisor 2

Rochester, NY · On-site

$27 - $28.20/hr

Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other ... Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Generous PTO & Paid Holidays ...

DePaul

Quality Management Specialist I

Rochester, NY · On-site

$23.20 - $24.70/hr

Responsible for Utilization Record Review functions to include Individual record audits, admission ... Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Generous PTO & Paid Holidays ...

DePaul

Quality Management Specialist I (DACC)

Rochester, NY · On-site

$23.20 - $24.70/hr

Responsible for Utilization Record Review functions to include Individual record audits, admission ... Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Generous PTO & Paid Holidays ...

DePaul

Quality Management Specialist I

Rochester, NY

$23.20 - $24.70/hr

Responsible for Utilization Record Review functions to include Individual record audits, admission ... Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Generous PTO & Paid Holidays ...

next page

Showing results 1-20

People also search for

All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Rochester, NY

Insurance Utilization Review information

See Rochester, NY salary details

$21

$41

$68

How much do insurance utilization review jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for insurance utilization review in Rochester, NY is $41.72, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What are the most common challenges faced by Insurance Utilization Review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in the Insurance Utilization Review position, and why are they important?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an Insurance Utilization Review job?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Rochester, NY? The most popular types of Insurance Utilization Review jobs in Rochester, NY are:
What are popular job titles related to Insurance Utilization Review jobs in Rochester, NY? For Insurance Utilization Review jobs in Rochester, NY, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Rochester, NY look for? The top searched job categories for Insurance Utilization Review jobs in Rochester, NY are:
What cities near Rochester, NY are hiring for Insurance Utilization Review jobs? Cities near Rochester, NY with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Residential Supervisor 2

Residential Supervisor 2

DePaul

Rochester, NY • On-site

$27 - $28.20/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Job description

Overview

DePaul is looking for a passionate mental health professional to lead our team at our Carriage Factory Apartment Treatment Program! The Residential Supervisor 2 is responsible for the overall operation of the Community Residence, including the resident care, supervision of staff, and monitoring of physical plant.

Why work for DePaul?

  • Make a positive difference in someone's life
  • Supportive work environment
  • We value diversity
  • Opportunity for professional development and career advancement
  • Excellent benefits and competitive wages 
  • Pay range for this position is $27-$28.20/hour based on experience 
Responsibilities

DIRECT SERVICE RESPONSIBILITIES:

  • Provide teaching, supervision, and support in accordance with OMH 593 and 595 including the following restorative services:  Assertiveness/Self-Advocacy Training, Community Integration/Resource Development, Daily Living Skills, Health Services, Medication Management/Training, Parenting Training, Rehabilitative Counseling, Skill Development, Socialization, Substance Abuse Services, Symptom Management.
  • Ensure that each resident receives comprehensive planning for admission, ongoing treatment and training, and discharge or transfer.  Ensure that each plan is complete and up-to-date in accordance with standards of practice and the New York State Office of Mental Health.
  • Observe, monitor, and document resident behaviors as well as their progress in accordance with agency standards.
  • Plan, implement, and supervise recreational activities.
  • Ensure that supervision and documentation of resident medications are in accordance with agency policies.
  • Provide case management/rehabilitation services to assigned residents including the coordination of services provided by outside agencies and professionals.
  • Perform any other duties necessary for the effective and efficient operation of the community residence.

    • ADMINISTRATIVE RESPONSIBILITIES:

  • Assign, train, supervise, and evaluate the daily activities of staff and volunteers, and schedule their hours to maintain appropriate and sufficient coverage.
  • Ensure that all required resident care documentation is completed in accordance with standards set by OMH and the agency.
  • Conduct in-service training and weekly staff meetings.
  • Oversee all financial transactions within the residence, including payroll, accounts payable, petty cash, recreation fund, and clients' personal allowances.
  • Supervise the ordering of food to maintain adequate supplies and meet nutritional standards within budget constraints.
  • Supervise the maintenance of the building and coordinate fire safety procedures.
  • Maintain a positive relationship with community groups, including the Community Advisory Board, to ensure continuity of care for residents.
  • Interview and make hiring recommendations to supervisor.
  • Attend staff meetings and trainings as required by supervisor and work as a member of the residential team for each resident.  Give relevant input for treatment team meetings, staff meetings, utilization reviews, and any other meetings.
  • Observe all safety rules and regulations for self and others.
    • Qualifications

    Education:       4 year degree in Human Services.

    Experience:     1 year experience in Human Services.

    Other:              Driving record that meets agency's Clean Driving Record Policy. Must be at least Eighteen (18) years of age.

    Work Environment

    The Carriage Factory Apartment Treatment Program provides consumers with the highest level of independence in a program licensed by the New York State Office of Mental Health. The program is designed to be a preparatory step before the consumer begins to live independently within the community. An emphasis is placed on increasing personal initiative and self-reliance. Staff make routine visits and are available 24-hours a day in case of an emergency.This full-time position is Monday-Friday, 8am-4:30pm.

    Benefits

    This position is eligible for the following for the following benefits:  Medical Insurance, Dental Insurance, Vision Insurance, Life Insurance, Generous PTO & Paid Holidays, 403B with Employer Match, robust Employee Assistant Program, Staff Recognition Program and Employee Discount Program.

    DePaul is an equal opportunity employer that values diversity.  All employment is decided based on qualifications, merit, and program need.

    Employment Type: FULL_TIME

    Apply